Advances in Nursing & Midwifery

Introduction: The impact of individual versus group-based physical activities on psychological well-being, particularly loneliness in the elderly, remains uncertain. We aimed to compare the effect of group and individual exercise on loneliness in the elderly.
Methods: The present study was a quasi-experimental study with pre-test and post-test design that investigated the effect of exercise on loneliness, involving 110 elderly in Alborz province, Iran in 2021. Participants were randomly divided into three study groups (control, individual exercise and group exercise). The UCLA Loneliness Scale was used to assess the level of loneliness sensing before, immediately and one month after exercises schedule.
Results: The results of intergroup comparison showed no significant difference across the three groups in the feeling of loneliness in the elderly before the interventions. Although no difference was found between individual-based and group-based exercise groups immediately after exercise, there was a meaningful difference between the control group and the other two interventional groups. The one-month trend of the change in loneliness score in both individually exercising (p = 0.002), and group-based exercising (p = 0.008) was shown to be significant.
Conclusions: Since this research demonstrates that both individual and group exercise activities can alleviate feelings of isolation in elderly populations, government officials should prioritize including group fitness classes in their health initiatives targeting senior citizens.

Context: In traditional communities, marriage is recognized as a mandatory requirement to having children and to achieving social status; given this context, singleness may unfavorably impact an individual’s psychological well-being. This holds particularly true for women. The purpose of the present review was to compare the single never-married women status in Western and Eastern societies.

Evidence Acquisition: Published data were gathered from PubMed, Google Scholar, Web of Science, and Iranian databases such as SID and Magiran. The keywords included “psychological health”, “social health”, “reproductive health”, “marriage”, “never-married women”, “singleness”, and “single women”. Databases were searched with no time limitation and in both Persian and English languages.

Results: Being single, particularly in old ages, has a variety of adverse psychological consequences in individuals, families, and communities, including depression, strained interpersonal relationships, isolation, rejection, sadness, and anxiety. Some outcomes are common, while others vary according to different cultures and religions, such as response to sexual needs.

Conclusions: Singleness have positive and negative effects on individuals. The mental burdens of singleness affect persons, families, and societies. Cultural and societal peculiarities define the way how to cope with the effects of singleness. Thus, identifying the social and psychological consequences of singleness and planning to address them in accordance with the cultures and religions can be an important step for improving the well-being of never-married women.

Abstract
Introduction: The effectiveness and safety of COVID-19 vaccines have been reported, but there is limited information on their real-world effectiveness and reports of breakthrough infections. This study aimed to determine the frequency of COVID-19 infections after vaccination among medical interns and personnel in Ardabil city in 2021.
Methods: This cross-sectional descriptive study included 330 medical interns and personnel from Ardabil city hospitals. Participants were required to provide consent, have received at least one dose of the COVID-19 vaccine, and not have hearing or speech problems. Data was collected using a researcher-made questionnaire and analyzed using SPSS software.
Results: Most of the individuals involved (59.7%) were aged between 20 and 30, and 58.5% were women. The majority of the participants were married (60.6%), while physicians and nurses were the most frequently observed professional groups (with 39.7% and 29.1% respectively). Sinopharm and AstraZeneca vaccines were the most commonly used (39.4% and 17.9%, respectively). The majority of participants (67.3%) received three doses of the vaccine, and 27.1% of participants (92 people) reported getting sick at least 2 months after receiving the COVID-19 vaccine. There was no significant association between demographic variables and post-vaccine infection.
Conclusions: Although a substantial number of participants were infected with COVID-19 following vaccination, the severity of the illness was mostly mild, demonstrating the value of vaccination in lessening the impact of COVID-19.

Abstract
Introduction: As divorce rates continue to rise, there is a critical need to explore effective interventions that can strengthen marriages and reduce family breakdown. This study aimed to investigate the effectiveness of group dialectical behavior therapy (DBT) in reducing the divorce propensity and self-differentiation in couples with marital conflict referred to the family court in Karaj City.
Methods: The present study employed a quasi-experimental pretest-posttest control group design. The target population comprised all couples who filed for divorce at the Karaj Family Court in 2023. A purposive sample of 32 participants meeting the study’s inclusion criteria was randomly assigned to experimental and control groups (n=16 per group). Participants completed the Divorce Propensity Questionnaire (DPQ) and Self-Differentiation Inventory (SDI) pre- and post-intervention. The experimental group received sixteen 90-minute group Dialectical Behavior Therapy (DBT) sessions. Data were analyzed using analysis of covariance (ANCOVA) in SPSS-27.
Results: The results revealed significant positive effects of group DBT. The results revealed significant positive effects of group DBT. The analysis shows that the Dialectical Behavioral Therapy group had a significantly lower divorce propensity score (89.31 ± 23.37) compared to the control group (123.13 ± 24.14) (F= 37.73, P<0.001). Moreover, their self-differentiation score was significantly higher (175.31 ± 16.85 vs. 125.75 ± 11.06) (F=99.49, P<0.001).
Conclusions: Based on the study's results, group DBT can be considered an effective intervention to reduce the divorce propensity and improve self-differentiation in couples referred to the family court.

Introduction: Despite the success in reducing neonatal mortality in Iran, it is still far from developing countries and some Asian countries in this field. This study seeks to identify access priorities in controlling neonatal mortality for planning. Therefore, factors affecting access can be a predictive factor in controlling neonatal mortality in future macro-level management policies.
Methods: This applied cross-sectional research was done by the factor analysis method based on four patterns of reducing neonatal mortality. After reviewing different texts and patterns, the common and non-common dimensions of these patterns were set in a comparative table. The results of comparative studies were designed in the form of a questionnaire and sent to 20 experts for reliability and validity. Validity was confirmed by CVI and CVR methods and reliability by Cronbach's method. To validate the model, the final questionnaire was completed and collected by interviewing 311 people from seven provinces in a multi-stage interview with the multi-stage random sampling method. Data were analyzed using SPSS25 and AMOS-18 software.
Results: A total of six factors were identified as effective in controlling neonatal mortality, which include access to health services, policy-making, health care delivery, health information systems, family participation, and evaluation. Among these, access to health services and evaluation had the highest and the least effects with 23.19% and 1.19% of explained variances, respectively.
Conclusions: The availability of a skilled and trained person and the guarantee of the national budget for the availability of these people are the most important factors in access to controlling the mortality rate.